Category: Jobs/Economic Impact

The most significant federal entitlement reform in our lifetime was a little noticed provision that Democrats included in the Affordable Care Act (Obamacare). The provision garnered almost no attention from the mainstream media or even from most conservative commentators. Yet according to the Medicare Trustees report that followed, this one provision eliminated $52 trillion of unfunded federal government liability – an amount that was more than three times the size of the US economy.

United States health spending is projected to rise 5.3 percent in 2018, reflecting rising prices of medical goods and services and higher Medicaid costs, a U.S. government health agency said on Wednesday, an upward trend it forecasts for the next decade.

The increase represents a sharp uptick from 2017 spending, which the U.S. Centers for Medicare and Medicaid Services (CMS) now estimates to have been a 4.6 percent climb to nearly $3.5 trillion. It had previously forecast a 2017 rise of 5.4 percent.

Amazon announced Tuesday that it will join with J.P. Morgan Chase and Berkshire Hathaway to wade into the jungle of U.S. health care, and the news slashed billions in stock-market value from health-care companies in mere hours. American health care could benefit from creative destruction, though this would be Amazon’s toughest fixer upper to date.

The announcement offered no details—nothing on if the companies will set up provider networks or walk-in clinics or what. But an early red flag: The press release says the group will form an “independent company that is free from profit-making incentives and constraints.”

The problem with U.S. health care is not an incentive for profit, which has driven innovation and cures for diseases like hepatitis C. The fundamental problem is that the cost of a service is disconnected from underlying value. Patients don’t know the price of services and consume health care as if it’s free since government or employers are the third-party payers for most Americans.

Congress is apparently not done cutting taxes, even after passing a $1.5 trillion tax overhaul last year.

The deal struck by Democrats and Republicans on Monday to end a brief government shutdown contains $31 billion in tax cuts, including a temporary delay in implementing three health-care-related taxes.

Those delays, which enjoy varying degrees of bipartisan support, are not offset by any spending cuts or tax increases, and thus will add to a federal budget deficit that is already projected to increase rapidly as last year’s mammoth new tax law takes effect.

Congressional Republicans are hoping to pass a temporary funding bill that would keep the government open until mid-February, thus allowing negotiations to continue on immigration and other matters. To attract more support for the stop-gap bill, Republican leaders have proposed combining it with other unrelated and more popular provisions, including a two-year delay of the so-called “Cadillac tax.” Delaying the “Cadillac tax” again — it was already pushed back once — is a bad idea. It would set back the cause of market-driven health care rather than advance it.

U.S. House Ways and Means Committee Chairman Kevin Brady said on Thursday getting rid of the so-called “Cadillac” tax on high-cost employer-provided health insurance could be part of the spending deal now under negotiation in Congress.

“We want to get rid of it,” Brady, a Republican, told reporters outside his office, adding that this could “possibly” be part of an agreement lawmakers are seeking to avoid a government shutdown on Jan. 19.

“Even Democrats who put that awful tax in place, believe it needs to be delayed. If we can find some common ground there that would be terrific,” Brady said.

Growth in U.S. health spending slowed considerably in 2016, rising by 4.3 percent, after two years of higher spending growth spurred by Obamacare and prescription drugs.

The slowdown in health spending growth was seen broadly across all major forms of private and public insurance, and in medical services, prescription drugs and other goods, according to an official analysis released Wednesday.

But because health spending grew faster, as it has for years, than overall gross domestic product, health spending’s share of the economy increased to 17.9 percent in 2016, up from 17.7 percent of the economy the year before.

A majority of voters back the idea of tying Medicaid eligibility to employment status as the Trump administration weighs whether to give more states the power to impose work requirements on the government health program.

In an Aug. 10-14 Morning Consult/POLITICO poll, 1,997 registered voters were asked whether they generally support requiring individuals to have a job in order to be eligible for the program. Fifty-one percent of voters said they support that proposal, while 37 percent said they oppose it. The survey has a margin of error of plus or minus 2 percentage points.

Although the GOP’s plan to repeal the Affordable Care Act industry taxes died with the party’s health care bill, it’s conventional wisdom that some of the taxes will still be delayed. But there’s no plan to do so yet.

Lobbying campaigns to repeal or delay the health insurance tax and the medical device tax are ramping up, yet there’s no clear vehicle for Congress to take action. Well-wired lobbyists and Hill aides say the appetite for doing anything major on health care isn’t really there.

“It is a have-to-get-done that’s really hard to get done,” said one lobbyist.